Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study
Objective: To assess the diagnosis, treatment outcomes, and predictors of mortality in adult tuberculosis (TB) patients in an urban setting with a high HIV prevalence. Methods: A retrospective study was conducted of adult TB patients aged ≥15 years who were treated at Connaught Hospital in Freetown,...
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doaj-2d0ab9c6cd604060b6ed0b3080ed2f1b2020-11-25T03:59:48ZengElsevierInternational Journal of Infectious Diseases1201-97122020-07-0196112118Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective studySulaiman Lakoh0Darlinda F. Jiba1Olukemi Adekanmbi2Eva Poveda3Foday Sahr4Gibrilla F. Deen5Lynda M. Foray6Wadzani Gashau7Christopher J. Hoffmann8Robert A. Salata9George A. Yendewa10College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone; Corresponding author. Division of Infectious Diseases, Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra LeoneCollege of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Medicine, University College Hospital, Ibadan, NigeriaGroup of Virology and Pathogenesis, Galicia Sur Health Research Institute, Complexo Hospitalario Universitario de Vigo, SERGAS-Vigo, Vigo, SpainCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; Department of Medicine, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra LeoneNational TB and Leprosy Control Programme, Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra LeoneCollege of Medical Sciences, University of Maiduguri, Maiduguri, NigeriaDepartment of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USADepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USADepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USAObjective: To assess the diagnosis, treatment outcomes, and predictors of mortality in adult tuberculosis (TB) patients in an urban setting with a high HIV prevalence. Methods: A retrospective study was conducted of adult TB patients aged ≥15 years who were treated at Connaught Hospital in Freetown, Sierra Leone from January through December 2017. Multivariate logistic regression was used to identify predictors of mortality. Results: Of 1127 TB cases notified in 2017, 1105 (98%) were tested for HIV, yielding a TB/HIV co-infection rate of 32.0%. Only HIV-tested cases (n = 1105) were included in the final analysis. The majority were male (69.3%), aged 25–34 years (29.2%), and had pulmonary TB (96.3%). Treatment outcomes were as follows: 29.0% cured, 29.0% completed, 0.5% treatment failure, 24.2% lost to follow-up, 12.8% transferred/not evaluated, and 4.5% died. The majority of deaths (80.0%, 40/50) occurred within 2 months of TB treatment initiation. Age 65 years or older (adjusted odds ratio 3.48, 95% confidence interval 1.15–10.56; p = 0.027) and HIV-positive status (adjusted odds ratio 3.50, 95% confidence interval 1.72–7.12; p = 0.001) were independent predictors of mortality. Conclusions: Suboptimal TB treatment outcomes were observed in Sierra Leone in 2017. More local and international action is warranted to help achieve the 2035 global TB elimination targets.http://www.sciencedirect.com/science/article/pii/S120197122030254XTuberculosisDiagnosisTreatment outcomesSierra Leone |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sulaiman Lakoh Darlinda F. Jiba Olukemi Adekanmbi Eva Poveda Foday Sahr Gibrilla F. Deen Lynda M. Foray Wadzani Gashau Christopher J. Hoffmann Robert A. Salata George A. Yendewa |
spellingShingle |
Sulaiman Lakoh Darlinda F. Jiba Olukemi Adekanmbi Eva Poveda Foday Sahr Gibrilla F. Deen Lynda M. Foray Wadzani Gashau Christopher J. Hoffmann Robert A. Salata George A. Yendewa Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study International Journal of Infectious Diseases Tuberculosis Diagnosis Treatment outcomes Sierra Leone |
author_facet |
Sulaiman Lakoh Darlinda F. Jiba Olukemi Adekanmbi Eva Poveda Foday Sahr Gibrilla F. Deen Lynda M. Foray Wadzani Gashau Christopher J. Hoffmann Robert A. Salata George A. Yendewa |
author_sort |
Sulaiman Lakoh |
title |
Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study |
title_short |
Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study |
title_full |
Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study |
title_fullStr |
Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study |
title_full_unstemmed |
Diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high HIV prevalence in Sierra Leone: A retrospective study |
title_sort |
diagnosis and treatment outcomes of adult tuberculosis in an urban setting with high hiv prevalence in sierra leone: a retrospective study |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 |
publishDate |
2020-07-01 |
description |
Objective: To assess the diagnosis, treatment outcomes, and predictors of mortality in adult tuberculosis (TB) patients in an urban setting with a high HIV prevalence. Methods: A retrospective study was conducted of adult TB patients aged ≥15 years who were treated at Connaught Hospital in Freetown, Sierra Leone from January through December 2017. Multivariate logistic regression was used to identify predictors of mortality. Results: Of 1127 TB cases notified in 2017, 1105 (98%) were tested for HIV, yielding a TB/HIV co-infection rate of 32.0%. Only HIV-tested cases (n = 1105) were included in the final analysis. The majority were male (69.3%), aged 25–34 years (29.2%), and had pulmonary TB (96.3%). Treatment outcomes were as follows: 29.0% cured, 29.0% completed, 0.5% treatment failure, 24.2% lost to follow-up, 12.8% transferred/not evaluated, and 4.5% died. The majority of deaths (80.0%, 40/50) occurred within 2 months of TB treatment initiation. Age 65 years or older (adjusted odds ratio 3.48, 95% confidence interval 1.15–10.56; p = 0.027) and HIV-positive status (adjusted odds ratio 3.50, 95% confidence interval 1.72–7.12; p = 0.001) were independent predictors of mortality. Conclusions: Suboptimal TB treatment outcomes were observed in Sierra Leone in 2017. More local and international action is warranted to help achieve the 2035 global TB elimination targets. |
topic |
Tuberculosis Diagnosis Treatment outcomes Sierra Leone |
url |
http://www.sciencedirect.com/science/article/pii/S120197122030254X |
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